Healthcare Provider Details

I. General information

NPI: 1447673603
Provider Name (Legal Business Name): DR FU REHABILITATION MEDICAL PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2014
Last Update Date: 01/23/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13710 FRANKLIN AVE SUITE L2
FLUSHING NY
11355-3835
US

IV. Provider business mailing address

4125 KISSENA BLVD 6MM
FLUSHING NY
11355-3150
US

V. Phone/Fax

Practice location:
  • Phone: 347-732-4297
  • Fax: 347-732-4299
Mailing address:
  • Phone: 718-785-7515
  • Fax: 347-732-4299

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. HONGWEI ZHANG
Title or Position: ATTENDING PHYSICIAN
Credential: MD
Phone: 347-732-4297